Clinical and Radiological Factors Affecting Thoracolumbar Fractures Outcome: WFNS Spine Committee Recommendations

Francesco Costa,Salman Sharif,Abdul Hafid Bajamal,Yousuf Shaikh,Carla D. Anania,Mehmet Zileli 대한척추신경외과학회 2021 Neurospine Vol.18 No.4

To obtain a list of recommendations about clinical and radiological factors affecting outcome in thoraco-lumbar fractures with the aim of helping spine surgeons in daily practice. A systematic literature search in PubMed and Google Scholar database was done from 2010 to 2020 on the topic “thoracolumbar fracture AND radiology AND surgical outcomes” and “thoracolumbar fracture AND radiology AND surgical outcomes.” A total of 58 papers were analyzed and WFNS (World Federation of Neurosurgical Societies) Spine Committee organized 2 consensus meetings to formulate the specific recommendations the first in Peshawar in December 2019 and in a subsequent virtual meeting in June 2020 to reach an agreement. Both meetings utilized the Delphi method to analyze preliminary literature review statements based on the current evidence levels to generate recommendations through a comprehensive voting session. Eight statements were presented and reached the consensus about this topic. A variety of clinical factors is known to influence outcome of patients with thoracolumbar fractures. Some of these are well-known established factors such as blood pressure augmentation and patient age, while some are not well studied. Overall, the quality of evidence is low and we need more randomized controlled studies to validate our results. Similarly, radiological factors that can predict outcome are well stated and there is a high accordance worldwide. In reverse, still under debate is the application to choose which surgical treatment is advisable based on them.

Real-life Efficacy of Omalizumab After 9 Years of Follow-up

Francesco Menzella,Carla Galeone,Debora Formisano,Claudia Castagnetti,Patrizia Ruggiero,Anna Simonazzi,Luigi Zucchi 대한천식알레르기학회 2017 Allergy, Asthma & Immunology Research Vol.9 No.4

Omalizumab is frequently used as add-on treatment to inhaled corticosteroids (ICS) and long-acting β2-agonists in patients with suboptimal control of severe asthma. Patients with severe asthma will typically require chronic treatment, although due to the limited amount of data available there are still some concerns about the safety and efficacy of long-term therapy with omalizumab. Herein, in an extension of a previous 4-year study, we report disease-related outcomes of 8 patients with severe persistent allergic asthma who have been followed for a total of 9 years in a real-life setting. Both quality of life (QoL) (evaluated using the Juniper Asthma-Related QoL Questionnaire [AQLQ]) and forced expiratory volume in 1 second (FEV1) showed sustained improvement at 9 years. The median values of AQLQ and FEV1 at 4 years were 5.5 and 82.0% compared to 5.9 and 85.5%, respectively, at 9 years, which were all significantly increased from baseline. After 9 years, the mean annual number of severe exacerbations was 0.63 compared to 5 at baseline. There also appeared to be a trend toward use of a lower dose of ICS at longer follow-up times. After 9 years, there were no safety concerns for continued use of omalizumab, and no asthma-related hospitalizations or emergency department visits were documented over the last 5 years. The present analysis is the longest reported clinical follow-up of omalizumab. Long-term maintenance treatment with omalizumab for up to 9 years is associated with continued benefits in reducing symptoms, exacerbations, and medication burden without any safety concerns.

Exon deletions of the phenylalanine hydroxylase gene in Italian hyperphenylalaninemics

Francesco Calì,Giuseppa Ruggeri,Mirella Vinci,Concetta Meli,Carla Carducci,Vincenzo Leuzzi,Simone Pozzessere,Pietro Schinocca,Alda Ragalmuto,Valeria Chiavetta,Salvatore Miccichè,Valentino Romano 생화학분자생물학회 2010 Experimental and molecular medicine Vol.42 No.2

A consistent finding of many studies describing the spectrum of mutant phenylalanine hydroxylase (PAH)alleles underlying hyperphenylalaninemia is the impossibility of achieving a 100% mutation ascertainment rate using conventional gene-scanning methods. These methods include denaturing gradient gel electrophoresis (DGGE), denaturing high performance liquid chromatography (DHPLC), and direct sequencing. In recent years, it has been shown that a significant proportion of undetermined alleles consist of large deletions overlapping one or more exons. These deletions have been difficult to detect in compound heterozygotes using gene-scanning methods due to a masking effect of the non-deleted allele. To date, no systematic search has been carried out for such exon deletions in Italian patients with phenylketonuria or mild hyperphenylalaninemia. We used multiplex ligation-dependent probe amplification (MLPA), comparative multiplex dosage analysis (CMDA), and real-time PCR to search for both large deletions and duplications of the phenylalanine hydroxylase gene in Italian hyperphenylalaninemia patients. Four deletions removing different phenylalanine hydroxylase (PAH) gene exons were identified in 12 patients. Two of these deletions involving exons 4-5-6-7-8(systematic name c.353-?_912 + ?del) and exon 6(systematic name c.510-?_706 + ?del) have not been reported previously. In this study, we show that exon deletion of the PAH gene accounts for 1.7% of all mutant PAH alleles in Italian hyperphenylalaninemics.

Rapidly Progressive Malignant Pelvic Perivascular Epithelioid Cell Neoplasm (PEComa) Associated with Eggerthella lenta Bloodstream Infection

Stefano Cacciatore,Carla Recupero,Claudia Massaro,Daniele Elmi,Domenico Fusco,Vanessa Badiali,Vincenzo Brandi,Damiano Arciuolo,Fabio Marazzi,Francesco Landi 대한노인병학회 2022 Annals of geriatric medicine and research Vol.26 No.4

Perivascular epithelioid cell tumors (PEComa) are rare mesenchymal neoplasms composed of cells that express melanocytic and myogenic markers and grow around small blood vessels. PEComa often show benign behaviors but can also be highly aggressive. In frail and more complex patients, many conditions can overlap, compounding the diagnostic and therapeutic difficulties inherent in rare diseases. Moreover, the complexity of modern patients introduces new and significant players in host-microbe interactions, and emerging pathogens represent a relevant challenge to modern healthcare. Among these pathogens is Eggerthella lenta, an anaerobic gram-positive bacterium of the normal gut microbiota associated with life-threatening infections. Here, we present a case of malignant pelvic PEComa with rapid metastatic progression in a 73-year-old man who presented with an E. lenta bloodstream infection. Approaching differential diagnosis with open-mindedness may assist in better imaging interpretation, surgery scheduling, and proper treatment planning. The non-specific clinical presentation might delay timely diagnosis, while the absence of well-consolidated guidelines undermines the accurate management of the disease, for which strict follow-up can favor better outcomes. Progress in diagnostic techniques, such as the implementation of MALDI-TOF (matrix-assisted laser desorption/ionization-time of flight) mass spectrometry for micro-organism identification, helps with a more accurate pathogen diagnosis and characterization. This allows the implementation of the most appropriate therapy, as well as better surveillance of antibiotic resistance, infection prevention, and control measures. Nevertheless, a good dose of wisdom is vital to avoid overlooking potentially harmful pathogens, particularly in frail individuals.

Use of aglepristone for the treatment of P4 induced insulin resistance in dogs

Enrico Bigliardi,Carla Bresciani,Daniela Callegari,Francesco Di Ianni,Giorgio Morini,Enrico Parmigiani,Ezio Bianchi 대한수의학회 2014 Journal of Veterinary Science Vol.15 No.2

Insulin resistance (IR) in dogs is suspected whenhyperglycemia is present despite administration of insulindoses greater than 1.0 to 1.5 UI/kg. IR is caused by increasesin counter regulatory hormones concentrations (glucagon,glucocorticoids, catecholamines and growth hormone). Thisstudy was conducted to investigate the use of aglepristone(RU 46534), a P4 receptor antagonist, for the treatment of IRdiabetes mellitus in bitches during the luteal phase. Allanimals were treated with porcine insulin zinc suspension(Caninsulin) and aglepristone (Alizin) 10 mg/kgsubcutaneously at day 1, 2, 9 and 17 from diagnosis. At day5, no significant variation in glycemia was shown. At day 12and 20, serum glucose concentrations were significant lower(p < 0.05). From day 12 the insulin dose was reduced to 0.8IU BID. Insulin was reduced in the following weeks andglycemia was controlled.

Arsenic Uptake and Partitioning in Grafted Tomato Plants

Silvia Rita Stazi,Carla Cassaniti,Rosita Marabottini,Francesco Giuffrida,Cherubino Leonardi 한국원예학회 2016 Horticulture, Environment, and Biotechnology Vol.57 No.3

Arsenic is a toxic and cancerogenic metalloid that poses a threat to food crop consumption. Previous studies have shown that grafting vegetables onto certain rootstocks may restrict the uptake of some toxic metals, such as cadmium, lead, and so on, but no such study has investigated the uptake of arsenic. The aim of this work was to determine the following: i) if grafting can influence and reduce arsenic translocation in the root and/or aerial organs; ii) how tomato plants irrigated with arsenic-enriched nutrient solution (100 μg·L-1) accumulate this metalloid; and iii) if arsenic poses a potential risk to fruit quality. We found that differences in plant growth and the qualitative traits of fruits were mainly related to the adopted rootstock rather than to the addition of arsenic. Grafting influenced metalloid accumulation in roots and its translocation from roots to shoots and fruits. Tomato plants accumulated arsenic in their roots, and only a small portion was translocated to shoots and fruits, making the risk for human consumption negligible. Therefore, the uptake of this toxic element and its translocation are influenced by the rootstock utilized.

In-situ anodization of aluminum single crystals and aluminum alloys studied with X-ray reflectivity and Electrochemical impedance spectroscopy

Jonas EVERTSSON,Florian BERTRAM,Lisa RULLIK,Francesco CARLA,Roberto FELICI,Edvin LUNDGREN 한국진공학회 2016 한국진공학회 학술발표회초록집 Vol.2016 No.8

Early Management of Spinal Cord Injury: WFNS Spine Committee Recommendations

José Antonio Soriano-Sánchez,Salman Sharif,Francesco Costa,Jose Alberto Israel Romero Rangel,Carla Daniela Anania,Mehmet Zileli 대한척추신경외과학회 2020 Neurospine Vol.17 No.4

Scientific knowledge today is being generated more rapidly than we can assimilate thus requiring continuous review of gold-standards for diagnosis and treatment of specific pathologies. The aim of this paper is to provide an update on the best early management of spinal cord injury (SCI), in order to produce acceptable worldwide recommendations to standardize clinical practice as much as possible.The WFNS Spine Committee voted recommendations regarding management of SCI based on literature review of the last 10 years. The committee stated 9 recommendations on 3 main topics: (1) clinical assessment and classification of SCI; (2) emergency care and early management; (3) cardiopulmonary management. American Spinal Injury Association impairment scale, Spinal Cord Independence Measure, and International Spinal Cord Injury Basic Pain Data Set are considered the most useful and feasible in emergency evaluation and follow-up in case of SCI. Magnetic resonance imaging is the most indicated examination to evaluate patients with symptomatic SCI. In early phase, correction of hypotension (systolic blood pressure<90 mmHg), and bradycardia are strongly recommended. Surgical decompression should be performed as soon as possible with the ideal surgical time being within 8 hours for both complete and incomplete lesions.

Atypical Presentation of Pill Aspiration in Older Adults with Dysphagia: A Picture Not To Be Forgotten

Stefano Cacciatore,Vincenzo Brandi,Camilla Cocchi,Daniele Elmi,Giordana Gava,Claudia Massaro,Celeste Ambra Murace,Carla Recupero,Matteo Tosato,Riccardo Calvani,Francesco Landi 대한노인병학회 2022 Annals of geriatric medicine and research Vol.26 No.3

Nonconventional clinical presentations of diseases are common in older adults. Even dramatic events, such as foreign body (FB) inhalation, can occur in a subtle and non-specific manner. Pill aspiration is a rare yet overlooked cause of airway injury. It accounts for approximately 7% of all FB aspirations. In contrast, oral dysphagia and polypharmacology, mainly administrated in solid oral dosage forms (SDOF), like tablets and pills, are common conditions in older adults. Herein, we present a case of SDOF aspiration in a 78-year-old man. FB inhalation developed with general clinical deterioration and neurological impairment (delirium) rather than overt respiratory symptoms. Bronchoscopy provided remarkable images of this unexpected finding. Caregivers and healthcare workers must be aware of the risk of SDOF aspiration and adopt proper safety measures. Early recognition and bronchoscopy for diagnostic and therapeutic purposes can be lifesaving in such cases.